We carried out a review of the data available to us about Hazelwood House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Hazelwood House, you can give feedback on this service.
Hazelwood House provides all single bedrooms, a range of suitable communal rooms and access to a rear garden with summer house.
We found the following examples of good practice
There were procedures in place to support safe visiting by people’s family members or professionals. Staff undertook screening of all visitors and rapid response lateral flow tests (LFT) were undertaken for visitors before they entered the home. Visitors were provided with Personal Protective Equipment (PPE) and guided to its safe use. However, we identified this procedure had not been fully followed during a family visit shortly before the inspection. The registered manager undertook to ensure the procedure was followed correctly on all occasions in the future.
The home was kept clean. Staff kept records of their cleaning schedules, which included additional cleaning high touch surfaces, such as light switches and door handles. The home had communal areas providing space for people to socially distance.
People were supported to safely access work placements and other activities they enjoyed.
People and staff were regularly tested for COVID-19. Staff completed an LFT test prior to each shift to ensure they were safe to support people. People were supported to have a test each month or undertake additional tests if required. Where necessary mental capacity legislation had been followed to ensure this was only done in people’s best interests. The registered manager understood the actions they needed to take should any tests return a positive result.
The service had a good supply of PPE to meet current and future demand. Staff were using this correctly and in accordance with current guidance and disposal was safe at the time of this inspection.
The provider had systems in place to support staff mental wellbeing.
Hazelwood House is a care home. It is registered to provide accommodation and personal care for up to eleven people and predominantly supports people living with a learning and physical disability. At the time of the inspection there were ten people living at the service.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 11 people. Ten people were using the service. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the surrounding residential area. There were deliberately no identifying signs outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
People’s experience of using this service and what we found
People told us they were happy living at Hazelwood House and felt supported to live their lives. They were supported to maintain their independence as much as possible and encouraged to participate in activities of daily living. One person told us, “Yes, I love it here.”
Staff were recruited safely, and staffing levels had been increased, which meant that people received the support they required to keep safe. Staff knew how to keep people safe from harm.
Staff demonstrated a commitment to providing person-centred care based on people's preferences and wishes. The staff team knew people well and had built trusting and meaningful relationships with them.
People received their medicines safely and as prescribed. Appropriate arrangements were in place for obtaining, recording, administering and disposing of prescribed medicines.
Staff had received appropriate training and support to enable them to carry out their role safely.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected these by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
Care plans were detailed and person centred. People were involved in deciding how they wished to be supported and in reviewing their care plans when needed. Information was available in a format they could understand.
Staff used positive communication techniques with people so that they felt listened to and valued according to their individual needs.
Staff were kind, patient and responsive to people's needs. People were treated with dignity and staff respected their privacy
People were supported to engage in a variety of activities of their choice, both in the home and out in the community.
The provider had systems and processes to monitor quality within the home. The registered manager understood their regulatory responsibilities and shared information with stakeholders in a timely way.
People, their families, staff and external professionals all told us that the registered manager was very supportive, and the home was well led.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 29 August 2018). There were four breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Hazelwood House is a 'care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Hazelwood House is a care service which provides accommodation for up to 11 people who have a learning disability or challenging behaviour. At the time of our inspection, there were 10 people living at the service. The service was arranged over three floors connected by three staircases. There were two bathrooms on the middle floor, a toilet on the ground floor, and a separate shower room at the rear of the building. There was a lounge, dining room and large garden that people could easily access. Most people were able to use the kitchen independently or with staff support if required.
There was a registered manager at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
The last comprehensive inspection of this service was in February 2016, when the service was rated Good. At this comprehensive inspection, we found the service was not meeting legal requirements and was rated Requires Improvement.
There were quality assurance systems in place based on a range of audits. However, we found these had not been effective in ensuring compliance with the regulations. We identified four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have taken at the back of the full version of the report.
Staffing levels were not sufficient to ensure that people received safe and person centred care at all times. There was no system in place to ensure staffing levels were assessed in consideration with people’s individual needs.
The provider and registered manager had a lack of understanding around their responsibilities of protecting people’s rights in line with the Mental Capacity Act 2005 and best interest decisions had not been completed appropriately.
People were not always able to access activities within the service or the local community in a way that was individual and person-centred.
People and their families felt the home was safe and staff were aware of their responsibilities to safeguard people from abuse.
People received their medicines safely. Staff who administered medicines had received training and had their competency to administer medicines assessed to ensure their practice was safe.
Procedures were in place to learn from adverse incidents and there were appropriate systems to protect people from the risk of infection.
Effective recruitment procedures were in place. New staff received a robust induction to their roles and existing staff were competent, received regular training and were supported appropriately.
People were treated in a kind and caring manner. We observed positive interactions between people and staff.
The environment was supportive of people’s needs. People’s bedrooms were decorated to each individual’s taste and contained personal possessions and photos.
People’s care plans contained detailed and person-centred information and were updated regularly. Relatives and professionals were considered in people’s care reviews.
Staff built positive relationships with people and their families. They used appropriate techniques to communicate effectively, promoted independence and involved people in decisions about their care.
People were encouraged to make decisions about how their care was provided, and staff supported people to be as independent as possible in their day to day lives.
Plans were in place to deal with foreseeable emergencies such as fire risk; staff we spoke with said they had had received training to manage such situations safely.
People were supported to maintain their health and well-being. Staff supported people to attend
appointments with healthcare professionals. People were encouraged to eat healthily and staff made sure people had enough to eat and drink.
There was a complaints policy in place and people felt able to raise concerns.
There was an open and transparent culture. Visitors were welcomed and the registered manager sought and acted on feedback from people.
This inspection took place on 04 September 2015. This visit was unannounced. At our last inspection on 07 January 2014 we found the provider was meeting all of the expected standards of care.
Hazelwood House is a home which provides accommodation and care for 11people who have a learning disability or an autistic spectrum disorder. The home was fully occupied at the time of our inspection.
The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People told us they felt safe living at Hazelwood House. Staff received safeguarding training and knew how to recognise and report concerns within their organisation and to appropriate authorities. Risks associated with the delivery of care had been identified and action taken to minimise those risks. People’s needs were assessed and updated along with risk assessments and care plans.
There were sufficient staff to support people with their care and social activities. Staff received suitable training and support to enable them to deliver the care required for people. Specific training was available to meet the identified specialist needs of people.
Medicines were safely administered and were stored in appropriate secure areas within the home. Staff received appropriate training to enable them to give medicines competently. They were observed and assessed to ensure they were safe to administer medicines.
People received effective care as their needs had been assessed prior to admission. Care plans were written to identify needs of people and contained sufficient information for staff to deliver care accordingly. The care plans were personalised and contained information about each person’s likes, dislikes, history and preferences.
People chose their meals and were supported to prepare their own and others meals in safety. The food was nutritious and sufficient. People were supported to maintain good health and had good access to GPs and other healthcare specialists.
There was a good atmosphere in the home and we saw people were happy with the staff who supported them. They told us bout good relationships they had and how they could share their concerns with the registered manager and staff. People and their relatives told us they were involved in planning their care and were able to make changes to their care plans if required.
The registered manager sought the opinions of people and staff regularly on aspects of care and improving service delivery and the environment. People regularly gave feedback and identified things they would like to change or new activities they wanted to try. Staff were encouraged to think of ways in which to enhance people’s lives and told us they were listened to by the registered manager when they made suggestions.
The service was well led and there was a positive culture which placed people at the centre of care they received. Relatives were kept up to date on events in people’s lives and were encouraged to maintain their relationships with people. Auditing systems were in place to ensure high quality care was delivered to people. The registered manager ensured other essential audits were regularly carried out.
We looked at care records for four people and saw these contained assessments of need, support plans and risk assessments. Essential information concerning communication, choices and likes were included in people's care records. We observed staff asking people what they would like to do before delivering support and care to them.
We spoke with three members of staff who shared with us their understanding of safeguarding vulnerable adults. They identified different forms of abuse and demonstrated how they would report a safeguarding concern. One person who used the service told us, "I would speak to my key worker or the manager if I was not being treated nicely." This showed people and staff were aware of abuse and how they would report concerns they found.
A member of staff said, "the manager supports me to do my job and I know I can speak to them about any problems in the workplace." Another member of staff said, "the training is excellent and this has helped me to progress in my job." We looked at staff records which showed staff were supported to develop new skills through supervisions, observed practice and team meetings.
The provider carried out regular audits to look at the quality of the service. These highlighted actions which the manager needed to take to improve the quality of the service. The manager recorded the actions they had completed.
We observed that staff communicated well with people and promoted a supportive environment. Effective recruitment procedures were in place to ensure staff had undergone the relevant checks before commencing their employment.
The building was fit for purpose and well maintained. We saw that a complaints policy was in place and that complaints received were handled in line with the policy.
They said that they would approach the manager and their support workers with any concerns and were confident these would be addressed. People told us that if they had any problems they could talk to the staff. Comments were 'my support worker helps me and I can discuss things with her.' Another person said that 'the girls are smashing' and the care was 'excellent.'
People discussed with us how they spent their time. One person said that they liked cooking and helping the staff with the evening meals. Another person told us that they went out with their relative on particular day once a week and enjoyed their time together. One of the residents showed us their room and said that they had everything they needed. They said that they enjoyed spending time in their bedroom watching television and the staff respected their privacy.